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Dr. Bob is Robert Hsiung, MD,
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Posted by blondegirl47 on July 18, 2003, at 10:45:26
In reply to Re: Strattera side effects, posted by gouda on July 18, 2003, at 10:26:25
That one of the reasons I went off, when the dosage went up, I would be very grumpy. Not to mention tired and hungry. I hope it helps in other areas.
Blondegirl
Posted by manyparts2001 on July 22, 2003, at 9:40:45
In reply to Re: Strattera day 3- Coffee w/ meds » Viridis, posted by blondegirl47 on July 18, 2003, at 7:48:26
Does anyone else find that they still need to take their Ritalin while on Straterra?
When Str. was first prescribed for me I abruptly stopped taking Ritalin after taking about 2/day, although sometimes I would take 3. I always took at least one, but mostly two. Anyway, after 2 weeks on Straterra only I found that I was very agitated, so out of curiosity I took a Ritalin and Voila' I felt better within the hour and my concentration was back on track. It seems that sometimes when I take just the Straterra I am easily agitated, but the combo of Straterra and 10 mg of Ritalin (generic) once or twice a day helps. Anyone else have similar experiences?
Posted by blondegirl47 on July 22, 2003, at 9:46:34
In reply to Straterra AND Ritalin, posted by manyparts2001 on July 22, 2003, at 9:40:45
Strattera put me to sleep, so I took it at night and took my adderall during the day. Strattera ended up not being for me so I discontinued it. I have heard others say they like it alot.
If you don't build gradually, you will really get the crankies. The 2nd and 3rd week I was really a grump. Then I started noticing I was hungry all of the time. I already have a weight problem so I decided it wasn't the drug for me.
Good luck with it.
Blondegirl
Posted by MomofBoys on July 22, 2003, at 12:10:58
In reply to Straterra AND Ritalin, posted by manyparts2001 on July 22, 2003, at 9:40:45
I take Straterra and Ritalin. Some days I feel wonderful and some days I feel cruddy. I don't know why and I don't understand. I just feel so energetic some days but other days I could just sleep the day away. My focus and concentration is much better but my motivation? well, that leaves something to be desired. I still procrastinate in a big way and freak out when I try to figure out what to tackle on my to-do list. Last night my hubby helped with housework which was great! But I want to be able to do it all!!!! I also take Lexapro 20.
Posted by blondegirl47 on July 22, 2003, at 12:54:44
In reply to Re: Straterra AND Ritalin, posted by MomofBoys on July 22, 2003, at 12:10:58
With Ritalin you have to be careful about how soon you eat after taking it. Its best to take on an empty stomach if you can tolerate it. Also, caffeine, anything ascidic and phosphoric acid will lower your absporption of ritalin. For me ritalin was too short acting to work well and the crash left me tired and unable to focus.
Strattera made me very sleepy, I had to take it at night before bed.
Hope this helps
Blondegirl
Posted by Kacy on July 22, 2003, at 16:30:12
In reply to Re: Straterra AND Ritalin » MomofBoys, posted by blondegirl47 on July 22, 2003, at 12:54:44
My experience with Ritalin and coffee was different. The coffee didn't interfere with Ritalin. To the contrary, if I didn't have coffee with 20 mg of Ritalin on an empty stomach (and no food afterward for 30-40 minutes) then the Ritalin didn't work.
My doctor is opposed to letting me use Ritalin or Adderal again with Strattera. I wish he realized how many of you use both.
Posted by CC67 on July 22, 2003, at 20:21:39
In reply to Re: Straterra AND Ritalin, posted by Kacy on July 22, 2003, at 16:30:12
I took straterra w/ adderall,and it worked better at lower dose straterra.I was up to 120mg a day on straterra,with 60mg adderall.
I have always done well on adderall. Its after 3pm
when adderall wears off,and thats why I tryed adding stratera.to extend,did not work well at least for me.
I do better on focalin and adderall.
I believe stims work better when caffeine intake is limited.I also believe stims work better in alkalinized envirorment. hope helps!cc67
Posted by blondegirl47 on July 23, 2003, at 7:38:42
In reply to Re: Straterra AND Ritalin, posted by CC67 on July 22, 2003, at 20:21:39
I agree about the caffiene, it makes your urine more ascidic so that you eliminate your medication faster. It difficult to find things that alkalinize. I know that baking soda does this, but it is also very hard on your body. Because of its high sodium it can make your blood pressure shoot up.
Blondegirl
Posted by blondegirl47 on July 23, 2003, at 7:42:33
In reply to Re: Straterra AND Ritalin, posted by Kacy on July 22, 2003, at 16:30:12
Have you considered a new dr? Stratterra put me to sleep. It also made me hyperfocus on thing I shouldn't have been focusing on. Let me rephrase that...I didn't use my self parenting skills with it so I hyper focused a lot. :)
Blondegirl
Posted by Kacy on July 23, 2003, at 10:06:32
In reply to Re: Straterra AND Ritalin » Kacy, posted by blondegirl47 on July 23, 2003, at 7:42:33
I wish I could get a new doctor, but I can't afford to change right now. As well, starting over is a demoralizing thought.
I told him two weeks ago that Strattera's sedative affects are a problem. However, I had told him that Strattera was my 'magic bullet' after I got great results from it in the beginning. Since the Ritalin and Adderal affects had always been minimal for me, he had been glad to switch me off it. Now, the magic bullet is not as magical, but it's a big help. I believe I need the combo, so I'll keep tryng to convince him.
My leftover pills are beckoning me to try the combo for a week. He hates that, though, and explaining to him what affect it had would be a problem. He does know I have them.
Like you, I am failing at self-parenting, but I am trying everyday to use the step up the drug is giving me. Unfortunately, I told him that I needed to try harder at that and that I had a lifetime of habits to change. Thanks to me, he is considering that the issue.
I'm his only patient on Strattera and he gets all his information from the drug company rep. So far, he said to switch to taking it at night. So far, I have forgotten every night.
I don't hyperfocus, but I'd love to. (Earth to Kacy, come in please.)
Posted by blondegirl47 on July 23, 2003, at 10:16:19
In reply to Re: Straterra AND Ritalin » blondegirl47, posted by Kacy on July 23, 2003, at 10:06:32
I keep my medication by my bed with a glass of water.
One session I explained to my pdoc that I had a very big project going at work that I had to be clear on and stopping my adderall to experiment with stratterra could lose me my job. Maybe you could do a search on the internet to find articles on taking both. Some pdoc's have such control issues.
My inner parent just told me to get my butt back to work, te hee :)
Later Blondegirl
Blondegirl
Posted by CC67 on July 23, 2003, at 19:09:28
In reply to Re: Straterra AND Ritalin » CC67, posted by blondegirl47 on July 23, 2003, at 7:38:42
Hi blondegirl,
I have also read Caffeine constricts blood flow to brain reducing the amount of drug that circulates.
I wanted to add that fruits like,apples,pineapple,
Vegetables,with exception to peppers,beets,are all alkalizing.
I Have taken my adderall w/apples,vegetables,etc..
when I needed to eat,with good results.
If you "google search" alkalinizing foods,etc..
Just a thought,hope that helps some!
CC67
Posted by Viridis on July 23, 2003, at 22:54:44
In reply to Re: Straterra AND Ritalin, posted by Kacy on July 22, 2003, at 16:30:12
I've looked briefly at some of the ADD boards, and many people use stimulants such as Adderall or Ritalin together with Strattera. I was using Adderall and recently decided to try Strattera. I told my pdoc that I didn't want to switch from one to the other and he agreed -- don't stop the Adderall, it's often better to take both. He said this was based on his (limited) experience with patients since Strattera was released, information given at seminars that he's attended on Strattera, and discussions with the drug co. reps. He gave me a bunch of Strattera to try along with another prescription for Adderall, and I really benefit from use of the two together.
There is nothing on Lilly's Strattera site (or anywhere else that I can find) that contraindicates taking stimulants simultaneously with Strattera. You might download the prescribing info from the drug co.'s site and show this to your doctor, and even ask that he check with them.
Also, don't be afraid to call Lilly yourself to discuss this -- I've done this before with other meds and gotten much better advice than many doctors (such as my GP) can offer. The drug companies are eager to interact with consumers and will give you very detailed information (it's great PR for them, plus you can actually speak with the people who developed and tested the meds).
From what I can tell, Strattera + stimulant combinations are pretty routine and safe, and this approach certainly works well for me.
Posted by manyparts2001 on July 24, 2003, at 4:15:42
In reply to Re: Straterra AND Ritalin » CC67, posted by blondegirl47 on July 23, 2003, at 7:38:42
I contact Eli Lilly yesterday for their input about the combination of the two and was told they did not have any studies or feedback on the safety or combining of thetwo. All they had was their own research, which is really limited from what I understand. It was just long enough to get approval; however, they are continuing the study and really appreciated my feedback. Plus, they did not have any studies on long term use of Straterra. What she did say was that Ritalin worked on a diffeent neurotransmitter in the brain than did Straterra. But, this was all of the information she had.
So, I said all of that to say again how much I appreciate everyone's feedback. Manyparts
Posted by blondegirl47 on July 24, 2003, at 8:31:34
In reply to Re: Straiter AND Ritalin, posted by CC67 on July 23, 2003, at 19:09:28
Thanks for the info.:) Question...wouldn't pineapple be too acidic? It is high in vitamin C.
I will do that search on alkalinizing foods.
Blondegirl
Posted by blondegirl47 on July 24, 2003, at 10:33:28
In reply to Re: Straiter AND Ritalin, posted by CC67 on July 23, 2003, at 19:09:28
This alkalizing stuff can be confusing. Vitamin C is supposed to lower absorption, but fruit juice alkalizes. Some of the alkalizing sites disagree on alkalizing food. I found one that had peppers in the alkalizing side. Anyway, thanks for the idea of looking up alkalizing foods. Its going to be very helpful.
Blondegirl
Posted by CC67 on July 24, 2003, at 23:27:58
In reply to Re: Straiter AND Ritalin » CC67, posted by blondegirl47 on July 24, 2003, at 10:33:28
Hi blondegirl47,
you are correct on the contradicting sites.
My understanding is that thee organic salts,like citrates are being converted into bicarbonates nd this would be akalizing.
I know ascorbic acid is not reccomended so I to would seperate something like orange juice by at a one hour interval.But I am out and about all day in service industry,and sometimes take pineapple as a fruit,just a few pieces dont seem to affect my stims.
I have also taken my adderall with 600mg calcium,and 250mg magnesium,with good results.
hope this helps some! CC67
Posted by AJY on July 27, 2003, at 5:36:22
In reply to Re: Strattera day 3- Coffee w/ meds » blondegirl47, posted by Viridis on July 18, 2003, at 1:41:20
Thank you for the information about lower doses and espcecially the starter pack to start. I'm not sure why my doctor is having such difficulty starting me low. Just returned from a funeral, where a fellow Strattera-ite offered great encouragement.
Posted by blondegirl47 on July 28, 2003, at 8:36:39
In reply to strattera and ritalin, posted by CC67 on July 24, 2003, at 23:27:58
Thanks for the info cc67. What kind of calcium do you take?
Have a great day!
Blondegirl
Posted by Mike Oxsbig on July 28, 2003, at 11:25:55
In reply to Re: Straterra AND Ritalin-UPDATE, posted by manyparts2001 on July 24, 2003, at 4:15:42
While admittedly sponsored by Eli Lilly, the makers of Strattera, Floyd Sallee, MD and Ph. D. (Professor of Psychiatry and Pediatrics) at Cincinnati Children's Medical spoke of his experience as part of the drug trials for Strattera. He made the following points that I found helpful:
1. While Strattera has a half-life of about 5.2 hours, and targets primarily norepinephrine, the drug indirectly impacts dopamine action that continues beyond the time the drug is in the system. Thus one a day dosing is all that is necessary in most cases.
2. Dosing levels are very conservative if one follows the FDA dosing guidelines. The FDA does not suggest above 100 mg/ day. That may not be high enough for patients who weigh more. A 1.4-1.6 mg/kg/day formula may be a more realistic target dosage. Dosages up to 200 mg/day may not be unreasonable. Dr. Salle does not feel that there are any significant risk even with overdosage.
3. The only 2 psychotropic drugs to worry about taking with Strattera are Prozac and Paxil (Well, and the MAO inhibotors which are extremely rarely used). Use smaller doses when using along side them.
4. There is no problem using Strattera along side the psychostimulants such as Ritalin, Concerta, Metadate or Adderall.
5. Strattera appears to carry over to the next morning, impacting in a positive manner.
6. Strattera is rapidly absorbed, with maximal plasma levels reached in 1-2 hours after dosing.
7. Strattera has been found to be helpful with tic disorders comorbid with ADHD. Does not exacerbate tics or Tourette's Syndrome.
8. Regarding how long before it makes an impact is fairly rapid, a conservative approach should be to wait two weeks once one has reached a normal optimal dosage before increasing again.
9. A starting dosage of about .5 mg/kg/day should be increased to target dosage after about 3-4 days. This helps minimize the impact of side effects if started with a full dosage.
10. Strattera does not appear to potentiate the impact of alcohol.
11. While chemically different than Prozac, it may be helpful to think of it as a cousin of Prozac in terms of the way it works. However, its action is very specific to norepinephrine. It also appears to target most specifically the prefrontal cortex of the brain, which is the main brain center implicated in executive function and ADHD problems.
12. There are some reports of sexual dysfunction side effects in adult use. > I contact Eli Lilly yesterday for their input about the combination of the two and was told they did not have any studies or feedback on the safety or combining of thetwo. All they had was their own research, which is really limited from what I understand. It was just long enough to get approval; however, they are continuing the study and really appreciated my feedback. Plus, they did not have any studies on long term use of Straterra. What she did say was that Ritalin worked on a diffeent neurotransmitter in the brain than did Straterra. But, this was all of the information she had.
>
> So, I said all of that to say again how much I appreciate everyone's feedback. Manyparts
Posted by CC67 on July 29, 2003, at 0:13:45
In reply to Re: strattera and ritalin » CC67, posted by blondegirl47 on July 28, 2003, at 8:36:39
Blondegirl hi,I take "calcium carbonate/600mg+D 200I.U."----At same time I take the "250mg magnesium Oxide" "osco brand"same as "albertsons"
Sorry about taking so long to get back to you.
take care!! CC67.
Posted by blondegirl47 on July 29, 2003, at 8:17:16
In reply to Re: strattera and ritalin, posted by CC67 on July 29, 2003, at 0:13:45
No Problemo cc67, thanks for the info. :)
Blondegirl
Posted by reba on July 29, 2003, at 20:05:36
In reply to Re: strattera and ritalin, posted by reba on July 29, 2003, at 19:34:14
Hello all
I have been taking Strattera since February. Revently my doc and i decided that it might not be the best drug for me. Ive never tried any stims before so we decided to try adderal. We decided that the best option would be to go off the strattera at the same time I start the Adderol, becuase I am leaving to go back to school in 4 weeks. (Im a college student) The probelm is I feel horrible! the combo of going off the strattera and on the adderol has made me feel TERRIBLE so I wanted to know if anyone knows about the side effects of going off strattera because I cant find info about it anywhere!! PLEASE let me know if you have any feed back on what is normal while going off strattera, and also what is normal going off adderol! thanks!
Posted by teacherkris on July 29, 2003, at 21:44:27
In reply to Re: strattera and ritalin » CC67, posted by blondegirl47 on July 29, 2003, at 8:17:16
Hi all,
Well I haven't posted for awhile so here's the latest update. I'm still on 80 mg. I went back to takign it twice a day for awhile to try to alleviate the afternoon tiredness. It helped but I got sick of having to remember so I just recently went back to once a day and the tiredness is gone. I've been on Strattera since February. The road to here was definitely rocky but worthwhile.
One of the main reasons I wanted to go on Strattera was to be able to take Excederin and Sudafed again since those two don't mix well with stimulants. Amazingly I haven't been sick since going on it until now. So Sunday was the big test. When taking Sudafed with Concerta/Ritalin I felt like I was losing my mind and was on massive amounts of speed. I have nothing like that now with Strattera. I feel maybe a little more spacey than normal but nothing major. I'm so thrilled to be able to take it again! Just thought I'd let you all know!
Posted by fallsfall on July 29, 2003, at 22:19:45
In reply to strattera WITHDRAWL?, posted by reba on July 29, 2003, at 20:05:36
I could be wrong, but I thought that it was OK to just stop the Strattera. There is a Strattera website (http://www.strattera.com/index.jsp) that will have all the details. I can't give you personal information because I'm still taking my Strattera.
Good Luck
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